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Review
. 2022 Mar 1;21(1):1105-1118.
doi: 10.1007/s40200-022-01013-3. eCollection 2022 Jun.

The association of dietary insulin load and index with the risk of cancer and cancer mortality: a systematic review and meta-analysis

Farshad Teymoori  1   2 , Ebrahim Mokhtari  1 , Alireza Bahrami  3 , Hossein Farhadnejad  1 , Mina Azadi  2 , Milad Nazarzadeh  4 , Mohammadreza Vafa  2   5
Affiliations
Review

The association of dietary insulin load and index with the risk of cancer and cancer mortality: a systematic review and meta-analysis

Farshad Teymoori et al. J Diabetes Metab Disord. .

Abstract

Purpose: Insulin levels play an important role in cancer development. However, the link between an insulinogenic diet and cancer is still unclear. Therefore, we performed a systematic review with meta-analysis to investigate the association between dietary insulin index (II) and load (IL) with cancer risk and mortality.

Methods: A comprehensive search between electronic databases (Web of Science, PubMed/Medline, Scopus, and Google Scholar) was conducted to identify relevant studies up to January 2022. The relative risks (RR) and Odds ratios (OR) were extracted from eligible studies, and meta-analysis was performed to calculate the pooled effect size.

Result: 12 papers including 14 studies (10 cohorts and 4 case-control) were included for the meta-analysis. Among them, 10 studies reported effect size for the risk of cancer, and 4 studies reported effect size for cancer mortality. We observed no significant association between II and IL with cancer overall (RRII: 1.03, 95%CI: 0.91-1.17, RRIL: 1.16, 95%CI: 0.94-1.42) and in cohort studies, however, in case-control studies was related with higher odds of cancer (ORII: 2.30, 95%CI: 1.21-4.38, ORIL: 2.57, 95%CI: 1.64-4.02). Higher II and IL scores were associated with the increased risk of total (RRII: 1.29, 95%CI: 1.02-1.63) and (RRIL: 1.39, 95%CI: 1.06-1.83) and colorectal cancer mortality (RRII: 1.29, 95%CI: 1.13-1.48) and (RRIL: 1.37, 95%CI: 1.18-1.60).

Conclusion: Higher dietary II and IL were not associated with cancer risk in overall and cohort studies, whereas related with a higher risk of cancer in case-control studies. We observed a significant positive relation of II and IL with cancer mortality, especially CRC mortality.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-022-01013-3.

Keywords: Cancer; Cancer mortality; Insulin index; Insulin load; Meta-analysis.

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Conflict of interest statement

Conflict of interestThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of selection of the published studies
Fig. 2
Fig. 2
Forest plot for the association between dietary insulin index and the risk of cancer disease in adults, expressed as a comparison between highest and lowest categories of dietary insulin index. The diamond represents pooled estimates and its width shows a corresponding 95% CI from the random-effects analysis
Fig. 3
Fig. 3
Forest plot for the association between dietary insulin load and the risk of cancer disease in adults, expressed as a comparison between highest and lowest categories of dietary insulin load. The diamond represents pooled estimates and its width shows a corresponding 95% CI from the random-effects analysis
Fig. 4
Fig. 4
Forest plot for the association between dietary insulin index and the risk of cancer mortality in adults. The diamond represents pooled estimates and its width shows a corresponding 95% CI from the random-effects analysis
Fig. 5
Fig. 5
Forest plot for the association between dietary insulin load and the risk of cancer mortality in adults. The diamond represents pooled estimates and its width shows a corresponding 95% CI from the random-effects analysis
See this image and copyright information in PMC

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